Organization
DAVID HICKEY DENTAL LLC
Active
Other names
Mad River Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN SNIDER (OFFICE MANAGER)
(937) 864-2341
Entity
Organization
Contact information
Practice address
7544 DAYTON SPRINGFIELD RD, FAIRBORN, OH 45324-1902
(937) 864-2341
(937) 864-1997
Mailing address
PO BOX 338, ENON, OH 45323-0338
(937) 864-2341
(937) 864-1997
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2018
Last updated
03/21/2020
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